Effect of low-dose esketamine on pruritus during combined spinal-epidural block for labor analgesia
10.3760/cma.j.cn341190-20230220-00118
- VernacularTitle:小剂量艾司氯胺酮对腰硬联合阻滞分娩镇痛中瘙痒的影响
- Author:
Haoyu JIANG
1
;
Shoubo QUAN
;
Jingyi LI
;
Xuefeng ZHANG
Author Information
1. 东莞市松山湖中心医院麻醉科，东莞 523326
- Keywords:
Analgesia,obstetrical;
Anesthesia,epidural;
Anesthesia,spinal;
Labor,obstetric;
Pruritus;
Dose-response relationship,drug;
Esketamine
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(7):1032-1036
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of low-dose esketamine on pruritus during combined spinal-epidural block for labor analgesia.Methods:A total of 46 primigravida with full-term singleton pregnancy who underwent combined spinal-epidural block between November 2021 and April 2022 at Songshan Lake Central Hospital of Dongguan City were included in this study. These primigravida were divided into an experimental group and a control group ( n = 23 per group) using the random number table method. Five minutes prior to the administration of combined spinal-epidural block for labor analgesia, the experimental group received an intravenous injection of 0.125 mg/kg of esketamine, while the control group received an equal volume of 0.9% normal saline. Subsequently, 3 μg of Sufentanil was intrathecally injected, and an epidural catheter was inserted for patient-controlled analgesia. Pruritus grade, Visual Analogue Scale score, Ramsay sedation score, modified Bromage score, mean blood pressure, and heart rate were recorded before analgesia, 30 minutes after analgesia, and at the time of full dilation of the cervix. The duration of the active phase of the first stage of labor, the duration of the second stage of labor, the rate of instrumental delivery, the cesarean section rate, and neonatal Apgar score were recorded. Results:After 30 minutes of analgesia, the number of cases presenting with various grades of pruritus in the experimental group (no/mild/moderate/severe cases: 17/4/0/0, respectively) was significantly lower than that in the control group (no/mild/moderate/severe cases: 7/7/4/1, respectively; Z = -3.04, P < 0.01). By the time the cervices were fully dilated, the number of cases presenting with various grades of pruritus in the experimental group (no/mild/moderate/severe cases: 19/2/0/0, respectively) remained significantly lower than that in the control group (no/mild/moderate/severe cases: 10/5/4/0, respectively; Z = -2.75, P < 0.01). There were no statistically significant differences between the two groups in terms of Visual Analogue Scale score, Ramsay sedation score, modified Bromage score, mean blood pressure, heart rate, the duration of the active phase of the first stage of labor, the duration of the second stage of labor, the rate of instrumental delivery, and neonatal Apgar score (all P > 0.05). Conclusion:Low-dose esketamine may be effective in alleviating pruritus during combined spinal-epidural block for labor analgesia.
